| NPI | 1972723229 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: FL Me 72266) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL Me 72266) |
| Enumeration Date | 2007-04-27 |
| Last Update Date | 2013-09-18 |